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Outbreak of nosocomial urinary tract infections caused by Serratia marcescens
Abstract:
A prolonged outbreak (December 1980 to July 1982) of nosocomial urinary tract infections appeared to be due to strains of Serratia marcescens that were resistant to currently available antibiotics. The serotyping and antibiotic susceptibility patterns suggested a few endemic strains of serotypes O13, O2/3, O12/14, and nontypable strains. These strains were isolated from the urine samples of inpatients with urinary tract infections in the urology ward and in other wards. The strains of O12/14 (gentamicin susceptible) were replaced with those of O2/3 (gentamicin resistant) between June and September 1981, whereas the other serotypes were isolated continuously. They were resistant to sulbenicillin, cefmetazole, gentamicin, and amikacin, and susceptible to micronomicin and of loxacin, a new quinolone antibiotic. Most of them were also resistant to the disinfectant chlorhexidine, which had been used widely for hand washing in the hospital.
Insights
A prolonged outbreak of hospital-acquired urinary tract infections involved antibiotic-resistant Serratia marcescens strains. These resistant strains also showed resistance to the hospital
Area of Science:
- Microbiology
- Infectious Diseases
- Hospital Epidemiology
Background:
- Nosocomial urinary tract infections (UTIs) pose a significant healthcare challenge.
- Antibiotic resistance in hospital-acquired infections is a growing concern.
- Serratia marcescens is an opportunistic pathogen frequently implicated in nosocomial infections.
Purpose of the Study:
- To investigate the characteristics of a prolonged outbreak of nosocomial UTIs.
- To identify the causative strains of Serratia marcescens and their resistance patterns.
- To understand the epidemiological dynamics of the outbreak strains within the hospital setting.
Main Methods:
- Serotyping of Serratia marcescens strains isolated from patient urine samples.
- Antibiotic susceptibility testing to determine resistance profiles.
- Monitoring of strain prevalence and serotype replacement over the outbreak period.
Main Results:
- A prolonged outbreak (December 1980 to July 1982) of nosocomial UTIs caused by Serratia marcescens.
- Multiple endemic serotypes (O13, O2/3, O12/14, nontypable) were identified.
- Strains exhibited resistance to multiple antibiotics including gentamicin and amikacin, with a shift from gentamicin-susceptible to resistant strains observed.
- Resistance to the disinfectant chlorhexidine was noted in most strains.
Conclusions:
- The outbreak was characterized by multidrug-resistant Serratia marcescens strains.
- The emergence and persistence of resistant strains highlight the need for enhanced infection control measures.
- The findings underscore the importance of monitoring antibiotic and disinfectant resistance in hospital environments.